ArticleAllergy, asthma & immunology research2026
Risk Factors for COVID-19 mRNA Vaccine-Associated Exacerbations in Patients With Obstructive Airway Diseases: REsearch for Asthma and COPD ExacerbaTION Caused by COVID-19 mRNA Vaccination (REACTION Study).
Article in Allergy, asthma & immunology research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeCoronavirus disease 2019 (COVID-19) mRNA vaccines have reduced the severity and mortality of severe acute respiratory syndrome coronavirus 2 infection. However, several reports of asthma exacerbations following COVID-19 mRNA vaccination have raised safety concerns for patients with obstructive airway diseases. This study aimed to evaluate the risk of mRNA vaccine-associated exacerbations and identify associated clinical factors among patients with asthma and chronic obstructive pulmonary disease (COPD).
methodsThis multicenter historical cohort study enrolled 455 patients (387 with asthma, including 30 with COPD overlap and 68 with COPD) from 13 Japanese institutions between September 2022 and September 2024. Demographic data, pulmonary function, biomarkers, and questionnaire responses were collected. Exacerbation was defined as worsening of respiratory symptoms occurring within 1 week after vaccination. Independent risk factors were identified by multivariate logistic regression.
resultsPatients with asthma had a higher COVID-19 mRNA vaccine-associated exacerbation rate than those with COPD (14.5%
conclusionsPoorly controlled atopic asthma in younger individuals was associated with increased risk of COVID-19 mRNA vaccine-associated exacerbation. Despite this, the overall benefits of COVID-19 mRNA vaccination support its continued use, with an emphasis on optimizing asthma control beforehand in high-risk patients.
trial registrationUMIN Clinical Trials Registry Identifier: UMIN000049011.
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